Nearly 300,000 in Mass. seek coverage under healthcare law

Nearly 300,000 people have obtained health insurance through the state's landmark initiative over the last 18 months, officials announced yesterday, putting Massachusetts closer to the goal of covering nearly all residents.

The total surged to 293,000 in the past month as people hastened to sign up before year's end when a penalty kicks in, and officials predicted that thousands more would meet the deadline. Under the initiative, all residents must get insurance unless the state determines it is unaffordable for them.

"Massachusetts is proving that healthcare reform can work on the state level," Lieutenant Governor Tim Murray said yesterday at a State House event to announce the results. "Together, we've achieved what no other state has tried."

The state initiative is being closely watched across the nation, as other states consider how to move forward in the absence of any federal solution to the growing millions of uninsured people. In addition, nearly every candidate for president is proposing a national insurance effort and members of Congress are pushing their own plans.

Massachusetts officials said yesterday that they don't know how many people remain uninsured here. Estimates of the total without coverage last year ranged from the US Census's 657,000 to the state's 395,000. Based on those figures, the progress represents coverage for nearly one-half to three-quarters of the uninsured.

The majority of those newly insured have enrolled in one of two state programs - MassHealth and Commonwealth Care - under which they pay little or nothing, leading some critics to suggest that the state has accomplished only the easy part of its task. Others warn that some low-income patients are worse off now, because they previously got free medications and now must pay small fees they can't afford.

"We've spent a lot of money and not made a lot of progress, from my point of view," said Dr. Steffie Woolhandler, an associate professor at Harvard Medical School and cofounder of Physicians for a National Health Program. "Taking people out of 'free care' and putting them into insurance is more of an accounting change."

But the 293,000 new insured also include 63,000 who are paying private insurance premiums, either through their workplaces, insurers, or the state. State officials expect that number to hit 100,000 by year's end, because many people signing up through insurers have not yet been counted.

Andre Bastien Jr. is among those the insurance initiative has helped. The Milton man was without coverage for four months earlier this year after leaving a job to set up a mortgage company with his wife. While uninsured, he broke his ring finger and delayed getting care because of the expense. When he eventually saw a doctor, his finger had to be rebroken to be set properly. Bastien also needs care for a heart condition.

He and his wife, Gabrielle Rene-Bastien, purchased insurance through the state's Commonwealth Health Insurance Connector, getting comprehensive coverage for less than other plans they'd seen on the market.

"We can't afford not to have coverage," Rene-Bastien said.

The effort to enroll people is continuing, and officials also announced yesterday that they were extending the application deadlines for some programs that had previously had a Nov. 20 cutoff for end-of-year coverage. For example, people who have already been determined eligible for state-subsidized insurance have until late this month to complete the sign-up and pay their premiums. Healthcare advocates had pushed for the leeway.